Synapse 3D (US) Product Specifications：Z30N1138B

Synapse 3D V4.1US
Base Tools
Cardiac Tools (option)
Brain Perfusion (option)
Lung and Abdomen Analysis (option)
Liver and Kidney Analysis (option)
Nodule Analysis (option)
Colon Analysis (option)
Tensor Analysis (option)

Product Specifications
September 2014

Contact Information:
United States of America:
FUJIFILM MEDICAL SYSTEMS, U.S.A., Inc.
419 West Avenue, Stamford, CT 06902, U.S.A.

Manufacturer:
FUJIFILM Corporation
26-30 Nishiazabu, 2 Chome
Minato-ku, Tokyo, 106-8620, Japan

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Distribution of this document without agreement from FUJIFILM Corporation is strictly prohibited.

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Revision History
Date Comment
March 25, 2014 First version
July 16, 2014 Second edition
September 29, 2014 Third edition

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Table of Contents

1 Product overview ......................................................................................................................................... 17

2 Product configurations ................................................................................................................................ 18
3 Product package configurations ................................................................................................................. 20
4 Requirements............................................................................................................................................... 21
5 Function specifications summary............................................................................................................... 24
5.1 Function specifications summary for "Synapse 3D Base Tools"............................................................ 24
5.2 Function specifications summary for "Synapse 3D Cardiac Tools (option)"......................................... 25
5.3 Function specifications summary for "Synapse 3D Brain Perfusion (option)"..................................... 26
5.4 Function specifications summary for "Synapse 3D Lung and Abdomen Analysis (option)" ............... 26
5.5 Function specifications summary for "Synapse 3D Liver and Kidney Analysis (option)"................... 26
5.6 Function specifications summary for "Synapse 3D Nodule Analysis (option)" .................................... 27
5.7 Function specifications summary for "Synapse 3D Colon Analysis (option)"....................................... 27
5.8 Function specifications summary for "Synapse 3D Tensor Analysis (option)" ..................................... 27
6 System restrictions...................................................................................................................................... 28
6.2 Spec requirements for generic PCs.......................................................................................................... 30
6.3 Operational limitations on tablet devices ............................................................................................... 31
6.3.1 Snapshots that can be observed on a tablet device ............................................................................. 31
6.4 Operational limitations of offline VR ...................................................................................................... 31
7 Upgrade........................................................................................................................................................ 32
8 Function specifications detail..................................................................................................................... 34
8.1 Detailed functional specifications for "Synapse 3D Base Tools"............................................................ 34
8.2 Detailed functional specifications for "Synapse 3D Cardiac Tools (option)"......................................... 46
8.3 Detailed functional specifications for "Synapse 3D Brain Perfusion (option)" .................................... 52
8.4 Detailed functional specifications for "Synapse 3D Lung and Abdomen Analysis (option)" ............... 54
8.5 Detailed functional specifications for "Synapse 3D Liver and Kidney Analysis (option)"................... 57
8.6 Detailed functional specifications for "Synapse 3D Nodule Analysis (option)" .................................... 59
8.7 Detailed functional specifications for "Synapse 3D Colon Analysis (option)" ...................................... 60
8.8 Detailed functional specifications for "Synapse 3D Tensor Analysis (option)"..................................... 61

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(Note) The name Synapse 3D is the system name of related products. The “Synapse 3D Base Tools” product is
the baseline product package of Synapse 3D. This Product Specification is created specific for “Synapse 3D
Base Tools” and other packages, such as Cardiac Tools. However throughout this specification, the name
“Synapse 3D” is used generally where product name needs to be referred except where the full product name
“Synapse 3D Base Tools” or " Synapse 3D Cardiac Tools " is necessary.

Export Restrictions Applying to Synapse 3D

For models to which export restrictions apply, government approval obtained through due procedure is required
in order to export or otherwise remove such models from Japan.
Note that the same restrictions apply not only to the main unit but also to after-sale parts, service manuals and
service training (for exporting or transferring technology) when such items are dispatched or shipped to foreign
countries and when service training is given for trainees from foreign countries.

Copyright and trademarks of FUJIFILM Corporation

The Copyright (c) 1997-2014 of Synapse software belongs to FUJIFILM MEDICAL SYSTEMS, U.S.A., Inc. and
FUJIFILM Corporation.
The Copyright (c) 2010-2014 of Synapse 3D software belongs to FUJIFILM Corporation.

This computer program is protected by copyright law and international treaties. Unauthorized reproduction or
distribution of this program, or any portion of it, is strictly prohibited.
Synapse is a registered trademark of FUJIFILM Medical Systems U.S.A., Inc. and FUJIFILM Corporation.

Other holders’ trademarks

Microsoft, Windows, Windows Vista 7 and 8 etc. are the registered trademarks of Microsoft Corporation in the
U.S.A. and other countries.
All other company names and product names described in this manual are the trademarks or registered
trademarks of their respective holders.

Precautions

1. Unauthorized transfer or duplication of all or any part of the contents of this Product Specification is strictly
prohibited.
2. The contents of this Product Specification are subject to change without prior notice.
3. FUJIFILM Corporation accepts no liability whatsoever with regard to faults or damage arising from
installation, relocation, modifications, maintenance or repairs performed by anyone other than FUJIFILM
Corporation or a contractor approved by FUJIFILM Corporation.
4. FUJIFILM Corporation accepts no liability whatsoever with regard to faulty functioning of or damage to this
product caused by third-party products other than those supplied by FUJIFILM Corporation.
5. FUJIFILM Corporation accepts no liability whatsoever with regard to faults or damage arising from
modifications, maintenance or repairs in which replacement parts other than the genuine parts approved by

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FUJIFILM Corporation were used.

6. FUJIFILM Corporation accepts no liability whatsoever with regard to faults or damage arising as a result of a
failure to observe the safety precautions and operational procedures provided in the User Manual.
7. FUJIFILM Corporation accepts no liability whatsoever with regard to faults or damage caused by ambient
conditions that deviate from the operating conditions for this product, such as the power supply and
installation environment, that are specified in the Product Specification and User Manual.
8. FUJIFILM Corporation accepts no liability whatsoever with regard to faults or damage caused by natural
events such as fires, earthquakes, floods or lightning.

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Scope of this Document

This document serves as the product specification for Synapse 3D Base Tools and other packages for the
version specified on the front page. This specification includes features of Synapse 3D Base Tools,
requirements for the off-the-shelf hardware and software platforms used with Synapse 3D, important feature
limitations, and safety notifications for implementing and using Synapse 3D.

Indications for Use for Synapse 3D Base Tools

Synapse 3D Base Tools is medical imaging software that is intended to provide trained medical professionals,
with tools to aid them in reading, interpreting, reporting, and treatment planning. Synapse 3D Base Tools
accepts DICOM compliant medical images acquired from a variety of imaging devices including, CT, MR, CR,
US, NM, PT, and XA, etc. This product is not intended for use with or for the primary diagnostic interpretation of
Mammography images. Synapse 3D Base Tools provides several levels of tools to the user:

• Basic imaging tools for general images, including 2D viewing, volume rendering and 3D volume viewing,
orthogonal / oblique / curved Multi-Planar Reconstructions (MPR), Maximum (MIP), Average (RaySum)
and Minimum (MinIP) Intensity Projection, 4D volume viewing, image fusion, image subtraction, surface
rendering, sector and rectangular shape MPR image viewing, MPR for dental images, creating and
displaying multiple MPR images along an object time-density distribution, basic image processing, CINE,
measurements, annotations, reporting, printing, storing, distribution, and general image management
and administration tools, etc.

• Tools for regional segmentation of anatomical structures within the image data, path definition through
vascular and other tubular structures, and boundary detection.

• Image viewing tools for modality specific images, including CT PET fusion and ADC image viewing for MR
studies.

Indications for Use for Synapse 3D Cardiac Tools

Synapse 3D Cardiac Tools is medical imaging software used with Synapse 3D Base Tools that is intended to
provide trained medical professionals, with tools to aid them in reading, interpreting, reporting, and treatment
planning. Synapse 3D Cardiac Tools accepts DICOM compliant medical images acquired from a variety of
imaging devices including, CT, MR, NM, and XA. This product is not intended for use with or for the primary
diagnostic interpretation of Mammography images. Addition to the tools in Synapse 3D Base Tools, Synapse
3D Cardiac Tools provides the tools for specific clinical applications which provide targeted workflows, custom
UI, targeted measurements and reporting functions including:

• Functional cardiac analysis for CT left ventriculography images: which is intended to evaluate the
functional characteristics of heart.

• Functional cardiac analysis for non-contrast MR heart images: which is intended to evaluate the
functional characteristics of heart.

• Coronary artery analysis for CT coronary arteriography images: which is intended for the qualitative and
quantitative analysis of coronary arteries.

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• Coronary artery analysis for MR heart images: which is intended for the qualitative and quantitative
analysis of coronary arteries.

• Calcium scoring for non-contrast CT heart images: which is intended for non-invasive identification and
quantification of calcified atherosclerotic plaques in the coronary arteries using tomographic medical
image data and clinically accepted calcium scoring algorithms.

• Cardiac Fusion: which is intended to analyze cardiac anatomy and pathology with a fused image of
functional data (e.g. NM image, Bulls eye) and anatomical data.

• Aortic Valve Analysis for contrast CT heart images: which is intended for visualization of the heart, aorta
regions, and contour of the aorta, measurement of the vicinity of the aortic valve, measurement of the
calcification area in the aorta.

Indications for Use for Synapse 3D Brain Perfusion

Synapse 3D Brain Perfusion is medical imaging software used with Synapse 3D Base Tools that is intended to
provide trained medical professionals, with tools to aid them in reading, interpreting, reporting, and treatment
planning. Synapse 3D Brain Perfusion accepts DICOM compliant medical images acquired from CT and MR.
This product is not intended for use with or for the primary diagnostic interpretation of Mammography images.
Addition to Synapse 3D Base Tools, Synapse 3D Brain Perfusion provides the parameter images by
post-processing with dynamic scanned CT cerebral arteriography images and magnetic resonance images
(MR) with contrast agent to aid the assessment of cerebral blood flow. The parameter images are Cerebral
Blood Volume (CBV), Cerebral Blood Flow (CBF), Mean Transit Time (MTT), and Time To Peak (TTP).

Indications for Use for Synapse 3D Lung and Abdomen Analysis

Synapse 3D Lung and Abdomen Analysis is medical imaging software used with Synapse 3D Base Tools that is
intended to provide trained medical professionals, with tools to aid them in reading, interpreting, reporting, and
treatment planning. Synapse 3D Lung and Abdomen Analysis accepts DICOM compliant medical images
acquired from CT. This product is not intended for use with or for the primary diagnostic interpretation of
Mammography images. Addition to Synapse 3D Base Tools, Synapse 3D Lung and Abdomen Analysis is
intended to:

• use non-contrast and contrast enhanced computed tomographic images of the lung, provide custom
workflows and UI, and reporting functions for lung analysis including boundary detection and volume
calculation for pulmonary nodules in the lung based on the location specified by the user, segmentation
of bronchial tubes in the lung, approximation of air supply region by the user specified bronchial tube,
identifying, displaying and processing low absorption regions in the lung.

• use non-contrast CT images and calculate subcutaneous fat and visceral fat areas in 2D and both
volumes in 3D.

• analyze a bronchus path to reach a lung nodule using the volume data collected with CT, and simulate
insertion of bronchoscope into the path.

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Indications for Use for Synapse 3D Liver and Kidney Analysis

Synapse 3D Liver and Kidney Analysis is medical imaging software used with Synapse 3D Base Tools that is
intended to provide trained medical imaging professionals, including Physicians and Radiologists, with tools to
aid them in reading, interpreting, reporting, and treatment planning. Synapse 3D Liver and Kidney Analysis
accepts DICOM compliant medical images. This product is not intended for use with or for the primary
diagnostic interpretation of Mammography images. Addition to Synapse 3D Base Tools, Synapse 3D Liver and
Kidney Analysis uses contrast enhanced images of the body and provides custom workflows and UI, and
reporting functions for liver and kidney analysis including, liver and peripheral organ segmentation, and tumor
segmentation. Also segmentation of intrahepatic and peripheral vessels as well as the approximation of
vascular territories is provided using contrast enhanced computed tomographic images.

Indications for Use for Synapse 3D Nodule Analysis

Synapse 3D Nodule Analysis is medical imaging software used with Synapse 3D Base Tools that is
intended to provide trained medical professionals, with tools to aid them in reading, interpreting, reporting, and
treatment planning. Synapse 3D Nodule Analysis accepts DICOM compliant medical images acquired from
CT and PT.
This product is not intended for use with or for the primary diagnostic interpretation of Mammography images.
Addition to Synapse 3D Base Tools, Synapse 3D Nodule Analysis is intended to;

• use non-contrast and contrast enhanced computed tomography (CT) images, provide custom workflows
and UI, and reporting functions for nodule analysis including boundary detection of nodules based on the
location specified by the user, measurement of nodules, temporal comparison of nodule images, and
fusion of a CT nodule image on a PT nodule image.

• use positron emission tomography (PT) images, provide custom workflows and UI, and reporting
functions for nodule analysis including SUV measurement of nodules with sphere VOI based on the
location specified by the user, temporal comparison of nodule images, and fusion of a PT nodule image
on a CT nodule image.

Indications for Use for Synapse 3D Colon Analysis

Synapse 3D Colon Analysis is medical imaging software used with Synapse 3D Base Tools to accept,
display, and process DICOM compliant 2D and 3D medical images acquired from CT for the purpose of viewing
of a colon to detect polyps, masses, cancers, and other lesions. It is intended to be used by trained medical
professionals in reading, interpreting, reporting and screening. Addition to the general 2D and 3D image
processing and measurement tools available in Synapse 3D Base Tools, Synapse 3D Colon Analysis
provides custom workflows, UI, and reporting functions for colon analysis, including colon segmentation,
detection of the centerline of colon, fly-through of the entire colon, various rendering and visualization of colon,
comparing both prone and supine views, and electronic cleansing.

Indications for Use for Synapse 3D Tensor Analysis

Synapse 3D Tensor Analysis is medical imaging software used with Synapse 3D Base Tools to accept, display,
and process DICOM compliant 2D and 3D medical images acquired from MR for the purpose of viewing of local
water diffusion properties and directional dependence of the diffusion in the white matter. It is intended to be
used by trained medical professionals in reading, interpreting, reporting, screening and treatment planning.

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Addition to the general 2D and 3D image processing and measurement tools available in Synapse 3D Base
Tools, Synapse 3D Tensor Analysis provides custom workflows, UI, and reporting functions for tensor analysis
with neck and head MR images. It includes display of diffusion and FA color map images, white matter
tractography, dynamic review in MR, vessel and body visualization with registration of MR, CT, XA, PET and
NM.

Contraindications
None known.

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For Safe Operation

In this document, there are three types of explanatory notes as indicated by the marks shown below with their
respective meanings. Observe these warnings and cautions when using Synapse 3D.

Indicates an instruction that a user must

Warning
follow to use the product safely.

Indicates an operation that requires caution

Caution
to use the product safely.

Indicates operational information, additional

Note information, detail information, specifications, or
other information that may be helpful.

1. Precautions Before Operating This Workstation

Before using this workstation, please read “For Safe Operation” carefully so that you can operate it correctly.
Whenever you operate this workstation, be sure to observe all precautions. Failure to do so may subject you to
injuries or cause property damage.

The medical institution where the equipment is installed is responsible for its use and maintenance. This
workstation should not be used by persons other than suitably trained physicians or staffs.

Rx only in the United States (Federal law restricts this device to sale by or on the order of a physician)

2. Precautions When Using Electrical Equipment

Synapse 3D (workstation) must operate on the specified computers and monitors that satisfy the Safety
Standards and Regulations, Electromagnetic Interference Standards and Regulations, as well as Environmental
Regulations valid in each country or region where Synapse 3D is used. When discarding the hardware, the user
must comply with environmental regulations valid in each country or region. The environmental regulations
include, but not limited to, the EC directive 2002/96/EC of the European Parliament and of the Council of 27
January 2003 on waste electrical and electronic equipment (WEEE Directive).

Computers and monitors specified in the Synapse 3D product specification are designed to meet the
requirements of IEC60950 or equivalent standards but not in accordance with IEC60601-1 required for medical

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equipment installed in an environment where a patient may accidentally touch the equipment. To use the
workstation in such an environment, specific safety measures related to the computer to be used are necessary.
Consult the computer dealer for measures to be taken.

The computer to be used with Synapse 3D is classified as electrical equipment. To use the equipment correctly
and prevent any danger, please observe the following electrical equipment use precautions:

1. Observe the following precautions when installing the computer.

(1) Install the equipment in a dry place away from water.
(2) Install the equipment where it will not be adversely affected by atmospheric pressure, temperature,
humidity, ventilation, sunlight, dust or the presence of salt, sulfur or like substances in the air.
(3) Make sure the equipment will remain stable on a level surface and not be subjected to vibration or shock.
(4) Do not install the equipment in places where chemicals are stored or gases emitted.
(5) Supply the frequency, voltage and amperage specified for the computer.
(6) Connect the ground wire correctly.
(7) Connect all cables correctly and completely.
(8) If the computer is installed in a dusty environment, dust will accumulate in the power supply section,
possibly causing smoke or fire. Install the equipment in a place free from such influence.

2. If there is trouble with the computer, do not attempt to fix it randomly. Instead, indicate the problem as
appropriate and entrust repairs to a professional.

3. The supply voltage to the computer is 100 - 240 V depending on the model and region. Do not remove the
cover or remodel the computer.

4. Explosion Precautions
Since this equipment is not explosion-proof, do not use combustible and explosive gases near the equipment.

5. Electromagnetic Interference Precautions

The computer used for the workstation complies with the Electromagnetic Compatibility (EMC) standard for
general computers. However, there is no guarantee that interference will not occur in a particular installation.
If the computer is used in an environment such as in the vicinity of devices not compliant with the EMC
standard, interference may occur and cause the computer or other devices to malfunction.

6. Product media storage Precautions

Product media disc of Synapse 3D must be stored into media case. The media should not be stored at a high
temperature, high humidity or direct exposure to the sunlight place.

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3. Precautions Synapse 3D (Workstation) usage

1.
Synapse 3D is intended for use only as a supplement to traditional methods for interpreting radiological
images. Synapse 3D is only an aid or adjunct to processes or decisions that can be made without the use
of Synapse 3D. No diagnostic or treatment decisions or other decisions that may affect patient care should
be based exclusively on Synapse 3D.

2.
For exported images;

For images exported from Synapse 3D using e-mail, printing or any other mechanism, users must
ensure that recipients of exported images are familiar with this material. The precise appearance of the
image is dependent on the characteristics and settings of the hardware, including monitors, used. The
notes and cautions in this document related to the interpretation of displayed images apply equally to
these exported images.

3.
For studies to be used;

Users must be fully conversant with the limitations of the basic imaging modality and of ensuing image
processing. This includes understanding the limitations of the initial series acquisition, image processing
technology used, and image display methods. Also, be aware that medical imaging is valid only when
appropriate measures have been taken to obtain optimal images with correct orientation and correct
patient identifiers.

4.
For Image processing;

a. The user must keep the limitations of 3D image processing in mind when viewing 3D images. Small
pathologies may go undetected because the interslice distance is too great relative to the size of the
pathology. The creation of a 3D image using interpolation of data points between image slices based
on the original image can create a smooth-looking 3D image. The user must interpret the apparent
lack of pathology in the context of the inherent limitation in the resolution of the original slice images
as scanned.

b. Artifacts may appear in the image depending on the amount of image processing. When using an
image processing method, fully understand its characteristics.

c. The visualization settings of the 3D views may cause some anatomical features to be completely
transparent and therefore invisible. Synapse 3D allows users to hide anatomical features to
emphasize anatomy of interest. Users must take into account any actions and software behaviors of
this type when interpreting displayed images.

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5.
When installing, servicing and administrating Synapse 3D;

a. Set and install medical imaging equipment connected to the workstation properly, using the
installation specifications. If not, some errors may occur.

b. The installation, upgrade, system maintenance, system administration, and administration shall
only be performed by trained personnel.

c. Training materials must be created or updated using the correct version of service manual, user
manual, or other formal documents released as a part of the Synapse 3D product.

6.
While operating Synapse 3D;

a. Check the workstation before use to make sure that it operates normally.

b. In extended use of the workstation, take a 10 to 15 minute break after every hour to rest your eyes
and hands.

c. Do not turn off the power to the computer while using the workstation.

d. Perform the shutdown procedure specified in the operating system to end operation.

e. Do not change settings of the pre-installed Windows.

f. If the computer is forcibly terminated while using the system due to a power outage or other reasons,
data may be lost. It is recommended to use an uninterruptible power supply system. If a power outage
occurs and an uninterruptible power supply system is in use, terminate the workstation as soon as
possible.

g. When leaving an image displayed for a long time during operation, use the screensaver. If it does
not start running, contact your service engineer. If an image has been displayed for a long time, even
after the display changes, the image may be visible as a residual image on the next display. The video
card may become quite hot depending on the screensaver in use, causing a malfunction.

7.
For Hardware and software being used with Synapse 3D;

a. Do not install any hardware onto the workstation other than those designated by FUJIFILM
Corporation.

b. Do not install any software onto the workstation other than those designated by FUJIFILM
Corporation.

c. Do not uninstall originally installed software. Do not install any software other than that originally
installed.

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8.
Since the backlight (fluorescent tube) of the LCD monitor has a limited lifetime, the luminance (emitted
light amount) of the screen decreases as running time increases, and it may eventually make viewing
difficult. Check that the emitted light amount of the LCD backlight is appropriate before starting operation.
If not, contact your service engineer.

9.
When using a monitor or a LCD monitor;

a. White or black spots may appear on the LCD monitor. This is part of the normal wear and tear of an
LCD, and it is not a failure of the LCD monitor. These spots caused by LCD characteristics appear in
the fixed place at any time. Recognize their existence to prevent misinterpreting them as possible
medical abnormalities.

b. When the display resolution is too low, it may make viewing difficult. Make sure the settings are
appropriate for use.

c. When the luminance or contrast of the screen is set excessively high or low, it may make viewing
difficult. Make sure the settings are appropriate for use.

d. A color image may not be displayed with the correct gradation (grayscale) when viewed on a
grayscale monitor. Use a monitor that is appropriate for handling the images.

e. When interpreting an image on the monitor, be aware of the purpose and differences in the image
on the film. Image interpretation should be performed at responsibility of the user. For image
interpretation via the monitor, use high-definition and high-quality monitors as much as possible.

f. If the angle of view is not appropriate for image interpretation, it may affect correct image
interpretation. Check the angle of view, and adjust the monitor angle if necessary.

10.
Before interpreting an image, operate the workstation so that images are displayed at the appropriate size.
Always check the image size in the display scale.

11.
Regarding the direction and the object orientation in image;

a. The image display direction depends on the DICOM information attached to the image by the
medical equipment used to produce the image. When interpreting an image, make sure the direction
of the image is correct.

b. When displaying images in which it is hard to differentiate the left from the right (such as images of
kidneys and head), use the "L" or "R" displayed with the cube to confirm the orientation of the image.

The following image is displayed by reversing the right and left orientation of original image.

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12.
For measurements;

a. Inappropriate analysis results and measurements may be output if inappropriate points or lines are
used for the basis of analysis or measurement in applications. Set them appropriately.

b. When performing measurement, specify the coordinates and the units carefully.

c. For measurement, the workstation uses the DICOM information attached to the image by the
medical equipment used to produce the image. Medical practice using the measurement results
should be performed at the user's own responsibility.

d. Use the workstation taking into account errors between an image and the measurement result. An
image used for measurement may have errors in the length of the subject depending on the image
capturing method.

e. Note that if you measure the distance or other things on a saved image of CPR, the measurement
is performed on a curved surface.

f. Accuracy of the measurement functions is described in the measurement section in the User
Manual. Read and understand the accuracy and limitation information of measurement before use.

13.
Operate the security functions and procedures as specified to protect the workstation or patient
information from an unauthorized access.

14.
For installation environment;

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a. When disposing of the computer, make sure to erase patient information that may be recorded in
the magnetic disk (HDD) before disposal.

b. Installing the monitor in a place where strong light is emitted may prevent correct viewing because
the display is either directly exposed to the light or reflects the light. Install the equipment in a place
free from such influence.

c. Using the computer in a place where a strong magnetic field is present may cause the displayed
image to be distorted. Install the equipment in a place free from such influence.

d. A plasma monitor constitutively emits a small amount of infrared radiation from the panel surface.
Therefore, any equipment operating near the monitor that uses infrared rays may be affected. When
installing a plasma monitor, check that it does not affect neighboring devices. If the monitor interferes
with devices nearby, change the orientation of their transmitting/receiving section to prevent the
interference.

15.
When an error occurs;

a. If the workstation malfunctions, take action by following the messages displayed on the screen.

b. If an error occurs in the workstation, turn off the power, indicate that the equipment is faulty by posting
a notice or other means, and then contact your service engineer.

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 Synapse 3D (US) Product Specifications： Z30N1138B

1 Product overview
The product “Synapse 3D Base Tools” is a system that receives and retrieves DICOM data from modalities including
CT, MR, PET, XA, etc. and constructs 3D images and performs image analysis.

The product has the following features.

▀ Optimum operability
Users can configure a wide range of settings to enable optimum operations. They can enjoy stable
operations at an optimal speed without noticing any slowdowns thanks to optimized processing
based on the latest multi-core CPU and native 64-bit OS for data loading and 3D reconstruction.

▀ 3D image processing
The 3D processing is optimized to the sub-voxel level to achieve the best imaging performance while
providing the freedom to set object surface textures, 3D ray directions, and light attribute settings.
Useful operations, such as clipping and interactive processing, can be performed in real time.
Rendering can be performed at multiple resolutions.

▀ Various applications
Various, useful applications are available to use for different body parts and images from many
modalities. Extremely large images and image series (e.g. cardiac images) can be loaded directly
into memory. Operation is simple and easy using Image Intelligence™, Fujifilm’s proprietary image
processing technology.

▀ Query/Retrieve (Q/R) and image transfer

Q/R can be performed with Q/R compliant modalities and PACS, and images created and captured
on the product can be transferred to other DICOM servers.

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2 Product configurations
The product “Synapse 3D Base Tools” consists of the following two modules: Synapse 3D Server or Synapse 3D
Standalone for 3D image construction and analysis, and Synapse 3D Client.
(Standalone type is newly-included from ‘Synapse 3D V4.x’.)

There are two types of Synapse 3D client, one is dedicated client software which can launch Synapse 3D directly,
another is Synapse integration client software which can launch Synapse 3D through Synapse integration.

The following configuration is a connection example among Synapse 3D Server or Synapse 3D Standalone, image
modalities, Synapse Server (image data server) and Synapse 3D Client.

The number of Synapse 3D Servers varies according to the maximum number of concurrent connections. In the
case of multiple servers, high performance is realized with a server cluster where one machine works as the master
server and the others work as slave servers. When the master server receives a login request from a Synapse 3D
Client, the master server can select a login server automatically by confirming each server’s login status.

<Server and Client Configuration>

Scope of this product

Image Diagnostic
Device (CT, MR etc) Synapse 3D NAS
i Master server
(DICOM server)
Non-DICOM Image
DICOM Transfer
Diagnostic Device
G/W device ii
(CT, MR etc)

Synapse 3D Client Synapse 3D

v Synapse 3D Client Synapse 3D
Slave server
Synapse 3D Client Slave server
CD/DVD (PC, Tablet)

v
vi iii iv
Generic PC
Synapse Server
DICOM Printer
Image Server

Synapse クライアント
Synapse クライアント
Synapse Client
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i. DICOM Storage
Receive DICOM-compliant images such as CT and MR images
ii. Receive images through interface
For modalities that do not support the DICOM standard, separate DICOM conversion GW device is
required
iii. DICOM Q/R Storage
Display and analyze images by DICOM query and retrieval
iv. DICOM Printer
Enables DICOM printing
v. Local Data Import
Import DICOM data from CD/DVD
vi. Integration with Synapse
Refer DICOM database of Synapse

<Standalone Configuration>

Scope of this product

Diagnostic imaging NAS

equipment (optional)
(CT, MR, etc.)
i
Synapse 3D
CD/DVD
Non-DICOM Standalone PC 5) v
Diagnostic DICOM
imaging conversion ii
equipment G/W device
(ultrasound, etc.) iii iv
Image server DICOM Printer

i. DICOM Storage
Receive DICOM-compliant images such as CT and MR images
ii. Receive images through interface
For modalities that do not support the DICOM standard, separate DICOM conversion GW device is
required
iii. DICOM Q/R Storage
Display and analyze images by DICOM query and retrieval
iv. DICOM Printer
Enables DICOM printing
v. Local Data Import
Import DICOM data from CD/DVD

Notes
• With respect to connections to other systems, this covers those devices confirmed in advance by
connection testing etc.
• The standalone model does not support connections from tablet clients.

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3 Product package configurations

The following are product package configurations for Synapse 3D
□ Installation CD
● Synapse 3D Base Tools software and related software
● Synapse 3D Cardiac Tools (option)
● Synapse 3D Brain Perfusion (option)
● Synapse 3D Lung and Abdomen Analysis (option)
● Synapse 3D Liver and Kidney Analysis (option)
● Synapse 3D Nodule Analysis (option)
● Synapse 3D Colon Analysis (option)
● Synapse 3D Tensor Analysis (option)
● License manager application
● Service manual
● User manual
● Product specifications
● Upgrade kit

□ License key

License key is NOT included in following product package configurations.

Intended to be used for upgrades where dongles already exist.
□ Installation CD
● Synapse 3D Base Tools software and related software
● Synapse 3D Cardiac Tools (option)
● Synapse 3D Brain Perfusion (option)
● Synapse 3D Lung and Abdomen Analysis (option)
● Synapse 3D Liver and Kidney Analysis (option)
● Synapse 3D Nodule Analysis (option)
● Synapse 3D Colon Analysis (option)
● Synapse 3D Tensor Analysis (option)
● License manager application
● Service manual
● User manual
● Product specifications
● Upgrade kit

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4 Requirements
The following are the off-the-shelf software and hardware requirements used for Synapse 3D Base Tools.
Server(*1) Recommended requirements Minimum requirements(*6)
OS Microsoft® Windows Server® 2012 R2 Microsoft® Windows Server® 2008
Standard Edition (x64) Standard Edition SP2 (x64) (*7)
CPU (*5) Intel® Xeon® processor E5-2630 v2 Quad-core Intel® Xeon® processor
2.6GHz or greater, 2CPUs or more 2.0GHz or greater, 2 CPUs or more
Main memory 64GB
HDD SAS 10000rpm SATA 7200rpm

For OS and software: 80GB or greater

For setting: 100GB or greater
For images: depends on the image storage (*2)
Network adaptor (*4) 1000BASE-T or faster 100BASE-T
USB 1 port(*3)
Graphic VRAM : 1.0GB or more VRAM : 512MB
DirectX 11 is needed. DirectX 11 is needed.
Monitor SXGA (1280*1024) or larger
Single screen

Client Recommended requirements Minimum requirements(*6)

OS Microsoft Windows 8.1 (x64) Microsoft Windows 8.1 (x86)
Microsoft Windows 7 Professional (x86, x64)
SP1
Microsoft Windows Vista Business (x86, x64)
SP1 or later
Microsoft Windows XP Professional (x86,
x64) SP2 or later
CPU (*5) Intel® Core™ i5-4570 Intel® Core2Duo
CPU 3.2GHz or greater CPU 2.0GHz or greater
Main memory 4GB or more 1GB
HDD For OS and software : 80GB or greater
Network adaptor (*4) 1000BASE-T or faster 100BASE-T
Graphic VRAM : 512MB or more VRAM : 512MB
Monitor SXGA (1280*1024), UXGA (1600*1200), WUXGA (1920*1200)
Single or dual screen

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Tablet client Recommended requirements Minimum requirements(*6)

OS Microsoft Windows 8.1 Microsoft Windows 8.1
iOS 6.0 or later iOS 6.0 or later
Android 4.1.1 or later Android 4.0 or later
CPU Intel® Atom™ Z2760 Intel CPU 1.6Ghz or greater
CPU 1.8GHz or greater Apple A5 or greater for iOS
Intel® Atom™ 1.8GHz or greater for NVIDIA Tegra 3 1.0GHz or greater for
Windows Android
Apple A5X or greater for iOS
NVIDIA Tegra 3 1.6GHz or greater for
Android
Web browser Internet Explorer 10.0 for Windows
Safari for iOS
Google chrome for Android
Main memory 2GB or more 1GB or more
HDD For OS and software : 64GB or greater 16GB or greater
Wireless LAN IEEE802.11a/b/g/n Wireless LAN IEEE802.11a/b/g/n Wireless LAN

Monitor 2048x1536, 1920x1080, 1024 x 768

1280x800, 1024x768

Standalone Recommended requirements Minimum requirements(*6)

OS Microsoft® Windows 8.1(x64) Microsoft® Windows 8.1(x64)
CPU (*5) Intel® Xeon® processor E5-2630 v2 Intel® Xeon® processor E5-2630 v2
2.6GHz or greater, 2CPUs or more 2.6GHz, 2CPU
Main memory 16GB
HDD 1TB SATA 6.0Gb/s NCQ HDD (7200rpm) 500GB SATA 6.0Gb/s NCQ HDD (7200rpm)
RAID1 RAID1
Network adaptor 1000BASE-T or faster 100BASE-T
Graphic VRAM : 1.0GB or more VRAM : 512MB
DirectX 11 is needed. DirectX 11 is needed.
Monitor SXGA (1280*1024), UXGA (1600*1200), WUXGA (1920*1200)
Single or dual screen

*1 Please connect uninterrupted power supplies (UPS) to servers if necessary.

*2 Images will be stored in lossless compression format with about a 1/3 compression ratio with Synapse 3D default
settings.
[For example, in the case of 1000 CT image (512*512), 0.5 (MB/slice) * 1000 (slices) * 1/3 = 167 (MB) will be used.

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Image storage capacity can be expanded by using extra network attached storage (NAS)].
*3 This requirement is only for the master server. The slave server doesn’t need to satisfy this requirement.
*4 Configuration using a 1Gbps network is recommended. If the network load is high, performance may drop
significantly.
*5 Only Intel CPUs are supported.
*6 Other software or problems specific to hardware might affect this software behavior.
*7 This requirement is only for upgrade from V2 to V4.

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5 Function specifications summary

5.1 Function specifications summary for "Synapse 3D Base Tools"
The following is the function specifications summary for "Synapse 3D Base Tools".
Image management
● DICOM input: Receives images from DICOM devices
● DICOM output: Sends images to DICOM devices
● DICOM Q/R: Query/Retrieve image data to/from DICOM devices
● Study list display: Shows a multi-level study list including: Study, Series, Instance
● Search: Search by patient ID, patient name, study date, modality, comment, and body part examined
● Add comments: Adds comments to Study, Series
● Search condition preset: Sets up search conditions customizable for each user
● Referencing DICOM headers: Displays DICOM data elements of images and outputs them in CSV
format
● Data protection: Data protection at Study and Series level to prevent unintended data deletion
● Import and export: import DICOM files from HDD and optical drive, export DCIOM files to HDD
● Anonymization of patient information: Exports image data with anonymous patient information
● Export of converted image data: Converts DICOM images to general file format images (JPEG, etc.)
● Image storage: Converts created movie, captured images to DICOM image, general image files, or
general movie file and stores them
● User-customizable settings: Stores settings for each Synapse 3D login user account
● Online help: Displays a help file corresponding to the current operations and key word search
● Print: Prints to DICOM and Windows printers

Image processing and display function

● 3D display: display in VR, SSD, MIP, MinIP, Ray summation, CPR
● VR color template: Changes rendering parameters, provides live template
● Changing window width and window level: Sets up window width/level, gamma, edge enhancement,
and smoothing
● Measurement: Measures distance, angle, area, volume, and profile, displays histogram, and stores
measurement results
● Annotation: Annotate by arrows, dots, text, and balloons
● 3D clipping: Clipping the range being displayed in the format of cross section, sight-line, and sphere
● Mask editing: Smart cut, smart select, smart tracking, organs extraction, preset register and edit
● Multi mask: Stores mask information for up to 12 layers. Perform ADD/AND etc. operations between
masks
● Reformat: Reformats by line, sector, and circle
● SUV evaluation: Displays SUV of the inside of sphere VOI on PET images

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● Report: Creates, stores, and prints reports

● Snapshot: Stores and restores working status
● Surface rendering: Display polygon model and output polygon model to external files
● Offline VR: create offline content that can be displayed in pseudo-3D in a Web browser

Image application
● 2D Viewer: Simple viewer for 2D reading
● 3D Viewer: Displays 2D cross sections, 3D images
● 4D Viewer: Displays 4D cine play of multi-phase images, e.g., cardiac images, edits phase time
information
● 3D Comparison: Compares multiple series images in 2D cross section and 3D display
● Slicer: Application for observation of arbitrary cross section
● Dynamic Data: Displays profile curve and color map of dynamic images
● Fusion: Viewer superimposes two 3D intra/intermodality images
● 3D Compositor: Viewer displays multiple 3D images in the same coordinate space
● Vessel Extraction: Uses images pre-contrast and post-contrast agent, extracts and displays cerebral
blood vessels
●Nuclear Medicine Viewer: Overlay display of CT images with NM or PET images
● Combination: Combines multiple CT or MR images taken in two or more times.
● Sector MPR: Using single/multiple phase CT, MR images, observes sector or rectangular MPR images
● Dental MPR: Using CT image, creates and displays panorama image along dental arch and cross
section of Alveolar bone
● ADC Viewer: Using MR diffusion image, calculates and displays ADC map
● 2D Fusion: Viewer superimposes two 2D intra/intermodality images
●General CPR: Extraction and CPR display of vessel paths and the aorta; stenosis rate and color
mapping analysis; virtual stent graft
● MPR Reformat: Observation of arbitrary cross sections along the reference line using either line,
sector, or circle
● Tx Map: Creates a T2* Map using T2 images

5.2 Function specifications summary for "Synapse 3D Cardiac Tools (option)"

The following is the function specifications summary for "Synapse 3D Cardiac Tools (option)".
Image application
● Coronary Artery Analysis (CT): Using cardiac CT image, extracts coronary artery, displays CPR, and
measures stenosis and plaque
● Coronary Artery Analysis (MR): Using cardiac MR image, extracts coronary artery, displays CPR, and
measures stenosis
● Functional Cardiac Analysis (CT): Using single or multiple phase cardiac CT images, evaluates cardiac
function
● Functional Cardiac Analysis (MR): Using single or multiple phase cardiac MR images, evaluates

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cardiac function
● Calcium Scoring: Using cardiac CT image, displays color mapping of calcifications of the coronary
arteries , and calculates Agatston score
● Cardiac Fusion: Displays fusion image between cardiac structure image and cardiac function image
● Aortic Valve Analysis: Using single or multiple phase cardiac CT images, measure an aortic valve
● MR Flow Analysis: Calculates the blood flow volume and the flow velocity per heart rate velocity of an
arranged ROI
● 4-Chamber Analysis: Evaluates cardiac function in the four chambers using a single cardiac CT image
or multiple phase images
● Cardiac Ablation Analysis: Pre-operation simulation for ablation and post-operation observation

5.3 Function specifications summary for "Synapse 3D Brain Perfusion (option)"

The following is the function specifications summary for "Synapse 3D Brain Perfusion (option)".
Image application
● Brain Perfusion (CT): Using cerebral CT image, displays cerebral bloodstream parameter images and
measures ROI
● Brain Perfusion (MR): Using cerebral MR image, displays cerebral bloodstream parameter images and
measures ROI
● 4D Perfusion: Using multi-phase 3D whole-brain CT images, analyzes cerebral blood flow over time (in
4D)

5.4 Function specifications summary for "Synapse 3D Lung and Abdomen Analysis (option)"
The following is the function specifications summary for "Synapse 3D Lung and Abdomen Analysis (option)".

Image application
● 2D Fat Analysis (CT): Calculates percentage of visceral fat and subcutaneous fat
● 3D Fat Analysis (CT): Using abdominal 3D CT image, calculates volume and percentage of visceral fat
and subcutaneous fat
● Lung Analysis (CT): Using CT image, calculates volume of lung nodules and displays low attenuation
areas
●Lung Analysis Scope (CT): Extracts the bronchus from CT chest images and find the shortest path to
the tumor
●Lung Analysis Resection (CT): Using contrast-enhanced CT images, extract the lung, bronchus, PA,
and PV and display the results in 3D:

5.5 Function specifications summary for "Synapse 3D Liver and Kidney Analysis (option)"
The following is the function specifications summary for "Synapse 3D Liver and Kidney Analysis (option)".
Image application
● Liver Analysis (CT): Using contrast CT image, extracts liver and blood vessel regions and displays
results in 3D
● Liver Analysis (MR): Viewer and analysis dedicated to captured images using an EOB contrast agent

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●Kidney Analysis (CT): Using contrast-enhanced CT images of the kidney, extract the kidney and each
vessel area and display the results in 3D

5.6 Function specifications summary for "Synapse 3D Nodule Analysis (option)"

The following is the function specifications summary for "Synapse 3D Nodule Analysis (option)".
Image application
● RECIST tracker: Using CT image, observes temporal changes of a tumor and creates report
● PERCIST tracker: Using PET image, observes temporal changes of a tumor and creates report

5.7 Function specifications summary for "Synapse 3D Colon Analysis (option)"

The following is the function specifications summary for "Synapse 3D Colon Analysis (option)".
Image application
● Colon Analysis: path creation and observation of the colon using CT images

5.8 Function specifications summary for "Synapse 3D Tensor Analysis (option)"

The following is the function specifications summary for "Synapse 3D Tensor Analysis (option)".
Image application
●Craniotomy Simulator/Tensor Analysis: Tractography extraction and craniotomy simulation

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6 System restrictions
The following are restrictions for “Synapse 3D Base Tools.”
Item Description
Number of modality The maximum number of modality connections is 30,
connections And the maximum number of concurrent connections is 10.
Client connections In case of multiple servers’ configuration, the number of slave servers can be
expanded to three units.
The number of servers and the maximum number of concurrent connections
are as follows.
Number of Maximum number of
servers concurrent connections
1 unit 8
2 units 16
3 units 24
4 units 32

* Clients exceeding the maximum number of concurrent connections can not

connect to the server concurrently.
For example, in case of 2 servers and 16 maximum concurrent
connections, if there are 32 Synapse 3D clients in total, the connection
possibility is 50%.
* Each Synapse 3D Client can handle over 10000 slices (assuming standard
CT slice resolution (512*512)). (The limit depends on the physical memory
capacity.)
Number of The number of user accounts on the server is restricted to fewer than 500.
accounts However, on the condition that tracing of the workstation log level is turned
off, the limit is fewer than 2000 accounts.
Furthermore, by changing the DICOM data storage location to NAS, and then
changing the storage location user settings, the limit becomes fewer than
1000 accounts.
It is not possible to set up accounts for more than 10,000 people.
Tablet client To use a tablet client, a wireless network connection is needed.
connections
Tablet client license The user must have a license to use a tablet client. Purchase of a user client
access license is required for the user who will use the tablet separately from

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the terminal.

*Confirms next chapter ‘7 Upgrade’ about upgrade of this software from ‘Synapse 3D V2.x’ and ‘Synapse 3D V3.x’.

It is possible to connect to this product by installing dedicated client software on a pre-existing generic PC in the
facility.

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6.2 Spec requirements for generic PCs

The minimum specifications for a generic PC used as a client are listed below. These are minimum requirements.
However, even if the PC meets these requirements, it might not work due to hardware-specific issues, compatibility
with other software, etc.

(Minimum specifications for a generic PC)

Component Contents
OS Windows 8 (32-bit, 64-bit)
Windows 7 (32-bit, 64-bit)
Windows Vista SP1 or later (32-bit, 64-bit)
Windows XP SP2 or later (32-bit, 64-bit)
CPU Pentium 4 or higher
Web browser Internet Explorer 7.0 or later
Memory 1GB or more
Monitor resolution 1024 x 768
(No special requirements beyond these are specified. Nonetheless, the PC configuration may not work in some cases.)

The recommended specifications for a general-purpose PC are listed below. Even if the PC meets these
requirements, it might not work due to hardware-specific issues, compatibility with other software, etc.

(Recommended specifications for a generic PC)

Component Contents
OS Windows 8 (32-bit, 64-bit)
CPU Dual core CPU
Web browser Internet Explorer 9.0 or later
Memory 2GB or more
Monitor resolution 1920 x 1200, 1920 x 1080, 1600 x 1200, 1280 x 1024
(No special requirements beyond these are specified. Nonetheless, the PC configuration may not work in some cases.)

If these requirements are met by existing PCs in the medical facilities, they can be used after the following
checks are performed:
・ Confirmation of the above specifications
・ Actual operational verification

Note that a separate license must be purchased in order to install the software on a PC in the facilities.

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6.3 Operational limitations on tablet devices

The workstation software that runs on a tablet device is intended to be used for observing snapshots, reports, and
movies that were created on a dedicated client and stored on the server. Therefore, the functionality and user
interface differ from the dedicated client.

6.3.1 Snapshots that can be observed on a tablet device

The following applications permit the observation of snapshots on a tablet device:

♦ 2D Viewer (for observation of the original images)

♦ 3D Viewer
♦ 4D Viewer
♦ Nuclear Medicine Viewer
♦ Fusion
♦ 3D Compositor
♦ 2D Fat Analysis
♦ 3D Fat Analysis
♦ Sector MPR
♦ Liver Analysis
♦ Kidney Analysis
♦ Vessel Extraction
♦ Lung Analysis Scope
♦ 3D Viewer with VE
♦ Sector MPR
♦ Coronary Artery Analysis (CT)
♦ Lung Analysis Resection
♦ Colon Analysis
♦ Craniotomy/Tensor Analysis

6.4 Operational limitations of offline VR

Offline VR lets you observe 3D images in a standard Web browser without requiring special software. However,
because it requires loading and displaying a large number of images captured at specific intervals, incidents such as
memory shortages or images failing to display may occur depending on the operating environment.

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7 Upgrade
It is possible to upgrade to ‘Synapse 3D V4.x’ from ‘Synapse 3D V2.X’ or ‘Synapse 3D V3.X’.
An upgrade option needs to be purchased certainly for the upgrade.

The upgrade kit is included in the installation CD

It is possible to upgrade not only the software itself but also the software environments.
DICOM images could be migrated by a script attached with the upgrade kit.
A part of user setting (e.g. Color Template) could be taken over to ‘Synapse 3D V4.x’ by a script attached with the
upgrade kit.
Snapshot created in previous version ‘Synapse 3D V2.x’ can be analyzed on ‘Synapse 3D V4.x’ by using
dedicated application based on ‘Synapse 3D V2.x’, if original DICOM image are migrated. In this case, not the
latest communication method but the previous communication method using Terminal Service is applied.
(Snapshots created in ‘Synapse 3D V3.x’ can be loaded directly in ‘Synapse 3D V4.x’.)

A comparison of main configuration between ‘Synapse 3D V3.x’ and ‘Synapse 3D V4.x’ is shown as follows.

Item Synapse 3D V3.x Synapse 3D V4.x

Server OS Windows Server 2008 R2 Enterprise Windows Server 2012 Standard
Edition (64 bit) Edition (64 bit)
Standalone OS Windows 7 64-bit Edition Windows 8 64-bit Edition
Client OS Windows 7 64-bit Edition Windows 8 64-bit Edition
Tablet OS - Windows 8 32-bit Edition
Tablet support N/A Available (with feature limitations)
Features - Added new features below.
-MR Flow Analysis
-4D Perfusion
-Liver Analysis MR
-Tx Map
-4-Chamber Analysis
-Cardiac Abration Analysis
-Craniotomy/Tensor Analysis
-Kidney Analysis
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-Lung Analysis Resection

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8 Function specifications detail

8.1 Detailed functional specifications for "Synapse 3D Base Tools"
The following are the detailed functional specifications for “Synapse 3D Base Tools.”

General
Multi-user environment
● Different settings can be specified per user. The users can share the database
DICOM communication as a service
● DICOM communications can run as a service, and can work without users logging in
Online help
● Displays a help file corresponding to the current operations

Server/Client
Setting up login method
● In the case of multiple servers, the login server can be selected automatically according to the
server’s operating status
Restricting functions available to the client
● Ability to restrict functions. Major functions that can be restricted are:
setting of available printers, adjusting screen resolution, storage of images/reports/snapshots,
image import/delete/transfer/export
Monitoring client connections status
●Server’s login status can be checked through a Web monitor
● Ability to send a message to a connected client and to force a connection to close
Access from tablet devices
● Snapshots can be observed using a tablet-specific UI.
● When communication is disconnected, it can be re-connected and the operating state restored.

DICOM server
Data management with SQL Server
● PostgreSQL Server 2005 manages database
● Database backup and restoration can be performed using SQL Server Management Studio
Setting of local AE
● AE title and port can be configured
Maximum number of concurrent connections
● The number can be configured
Maximum P-DATA-TF length
● Can be specified for receive and send operations separately

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Authorization of SOP Class for communication

● SOP Class can be specified for communication authorization. UID of the SOP Class can be input
arbitrarily
Setting of remote AE
● MOVE-SCP, C-STORE-SCP, C-FIND-SCP, C-STORE-SCU, and C-FIND/MOVE-SCU can be set
up separately
●Transfer syntax for acceptance can be selected from implicitVRLittleEndian,
explicitVRLittleEndian, and losslessJPEG. Priority can also be configured
● Transfer syntax for proposal can be selected from implicitVRLittleEndian (always proposed),
explicitVRLittleEndian, and losslessJPEG
● Printer settings: color, print priority, print media, film output destination, magnification type,
structure information, smooth type, edge density, blank image density, edging, resolution (width,
height, length/pixel)
● Character code settings: Receive setting (C-FIND-RQ, C-FIND-RSP, C-STORE-RQ) and send
setting (C-FIND-RQ, C-FIND-RSP, C-STORE-RQ) can be set up separately.
Log
● Output level, storage period, maximum number of files, and automatic log deletion time can be
specified
Setting of storage path
● Ability to specify primary storage and reserve storage. (Data can be automatically moved to
reserve storage at specified time when usage of primary storage reaches a certain point or after a
certain period of time)
Automatic deletion
● Automatically deletes DICOM files in case of space shortage or after a specific period of time
● Recycling function.
Link with Synapse
● Specifies whether to show data in Synapse in study list when Synapse is connected
Auto sending
● Ability to send capture and snapshot images
Automatic retrieve
● Images that match certain criteria can be automatically retrieved from specified AE.

Data management
Local data search
● Search by patient ID, patient name, study date, modality, body part examined, and comment
Add comments to local data
● Adds comments to Study, Series
Preset search items for local data
● Search conditions can be set up by user
Display of DICOM header information of local data

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● Ability to show DICOM header information

Local data protection
● Protects the data from unintended deletion by the user and automatic deletion. Protection can be
set up to the level of Study, Series
Export of local data to fixed-drive
● Ability to export DICOM files (including DICOM-conversions of snapshot/movie/report ) to
fixed-drive (e.g., HDD)
● Ability to select DICOM tags whose information will be deleted to anonymize patient information
by using a settings file
● Exports simple viewer
● Exports DICOMDIR
Import image from CD/DVD/HDD
● Direct importation of DICOM files from a specified folder
Image export format
● Converts DICOM images to general format files and exports them
Image: JPEG, BMP, PNG
Movie: AVI, MPEG, WMV
Transfer, Q/R
● Image transfer from local data to another AE (C-STORE)
● Search (C-FIND) and retrieve (C-MOVE) from another AE
Search by patient ID, patient name, start date, end date, modality, comment
(Search function by comment is available only between two Synapse 3D DICOM Servers)
Retrieve data at the level of Study, Series, and Instance
Automatic image processing
● Generate automatic snapshot.
● Generate application auto start launcher.

Print
Print to DICOM printers
● Settings specified at time of print: page range, number of copies, print direction, film
Prior settings by service engineers: color, print priority, print media, film output destination,
magnification type, structure information, smooth type, edge density, blank image density, edging,
resolution (width, height, length/pixel)
Print to Windows printers
● Settings specified at time of print: page range and number of copies
Print preview
● Ability to print in additional arbitrary layouts by using a settings file
● Manages print queue of DICOM printers (display of data transfer status, cancellation of print
requests)
● Image adjustment from preview by WL/magnification

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● Sets up ON/OFF of scale bar and cube

● Sets up ON/OFF of image border
● Inserts scan lines on reference image
● Inserts arbitrary image into footer
● Adds left margin to create space for punch holes for filing
● Edits preview image

Common functions to all applications

2D cross section display
● Axial, coronal, sagittal cross section views
● Oblique cross section view at an arbitrary point

CPR display
● Straightened CPR
● Stretched CPR
● Projected CPR display
● Multi-path CPR display
● Automatic/manual extraction of path
● Automatic/manual extraction of path diameter
● Displays of graphs of average diameter, projected length of radius, area, and average intensity
● Measures size of stenosis of blood vessels, etc. by specifying at least one normal diameter
● Assigns up to four colors to blood vessels according to intensity values to overlay plaque portions
● SMIP display: MIP rendering display calculated from areas near surface regions
● Ability to change CPR display mode among MIP, MinIP, and Ray summation modes
● Orthogonal cross section view of image with smoothing filter or edge enhancement filter applied
● Connection of path
3D display
● Volume rendering (VR)
● Shaded surface rendering (SSD)
● Maximum intensity projection (MIP)
● Minimum intensity projection (MinIP)
● Ray summation (Raysum)
VR color template
● Changes parameters (ambient light, diffuse light, specular light, shininess, decay level, opacity,
color mixture, light source orientation, self shadow)
● Sets up the shape of opacity function (freehand, increase toward right, decrease toward right,
concave type, convex type)
● Copy and paste of color templates
● Displays 2D cross section in colors specified by the color templates
● Registers color templates as a group

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● Displays live color templates (Thumbnail images of the current 3D image after applying registered
templates)
● Export and import color templates
● Share color templates among users
Changing window width and level
● Applies to MIP, MinIP, Ray summation of 2D and 3D views
● Gamma conversion
● 2D cross section view with smoothing filter or edge enhancement filter applied
● Pseudo-color settings such as normal display, reverse display, and individual pseudo-colors can
be specified
● Preset registration and recall of window width, window level, and pseudo-color
● Shared presets among users
Movie creation
● Creates movies by paging 2D cross sections in specified range
● Creates 3D movies by registering key frames based on changing parameters, e.g., orientation,
magnification rate, clipping, color template. Key frames can be registered one by one or
automatically registered when a parameter changes. Selectable presets can be created
● Registers key frames as a preset
● Offline VR: can generate files that enable simple VR operations on any device using a Web
browser
● Converts created movies to private DICOM data and stores them. Can transfers them to other
servers
3D filtering
● Removes noise with a low-pass filter and smoothly displays images in 3D
Measurement
● Measures lines, projected line, polygonal lines, angles, intensity values, rectangles, ellipses,
polygons, freehand, boxes, spheres
● Calculates volume of mask region, and average/max/min/standard deviation of intensity values in
3D images
● Calculates volume of mask region, and average/max/min/standard deviation of intensity values in
2D images
● Displays profile curve or histogram of each measurement
● Semi-automatic measurement of half-width
● Stores measurement results and graph in text file (.csv, .txt) or in capture image
● Ability to create ROI along the contour of an image by detecting contours during freehand
measurement
Annotation
● Annotation by arrows, points, line, cylinder, text, and balloons
● Ability to set up font, color, background color, and frame for text. Ability to register key words
● Ability to set up font, color, and background color for balloons. Ability to register key words

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3D clipping
● Specifies display range for X/Y/Z directions and specifies inside or outside clipping
● Plane clip, sight-line clip, sphere clip, local observation clip
● Centering
Magnifies using visible 3D areas as rotation center
● Ability to paste 2D cross section image on the plane of the border region of clipping
● Mask extraction of clipped areas
Mask editing
● Overlay mask region on 2D cross section view
● Undo/Redo up to 8 times
Extraction/removal of body parts: bone removal, bone extraction, bed removal, heart extraction,
colon extraction, lung field extraction, bronchus extraction, liver extraction, region search, vessel
tracking (all except blood vessel tracking are available for CT images only), spinal extraction,
body surface extraction, tube extraction, presets (registers extraction mode, target mask, and
color template to apply as one job)
● Smart cut (mask extraction/removal by surrounding a region) using polygon, curve, or freehand
● Smart select (extraction/removal by selecting an object)
● Smart tracking (extraction/removal by region growing)
● Dilation, Erosion
● Extracts a region within a specified threshold range as a mask. Applied to the whole image or an
ROI
● Extract a region with a specified opacity range as a mask. Applied to the whole image or an ROI
● Deletes continuous regions that have smaller volume than a specified mask value. Applied to the
whole image or an ROI
● Surface digger (removes surface mask, which is specified by ROI or point, along view direction)
● Adds/Deletes mask region from 2D cross section by using circle cursor
● Adds/Deletes a sphere mask on a clicked position
● Adds/Deletes mask corresponding to the regions created by interpolating multiple ROIs set on the
cross sections
● Function to fill in a mask on a 2D slice
Multi mask
● Registers and displays simultaneously up to 12 layers
● Status confirmation (current mask status) in real time
● Ability to reverse mask, perform ADD, SUB, AND, XOR operations between two layers
● Up to 8 layers can be used as additional mask storage (registration only)
Reformat
● Ability to reformat by line, sector, circle
● Plays cine of reformatted slices
● Saves reformatted slices as sequential images or a movie
SUV evaluation

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● Displays SUV (max, min, standard deviation) of sphere VOI of PET images
Supported manufacturers: Siemens, Philips, Shimadzu, GE
Report
● Ability to create reports
Ability to create and save reports as private DICOM data
Snapshot save
● Saves operation status
When the status is saved as private DICOM data, it can be transferred to another server for
restoration
Surface display
● Display polygon model and output polygon model to external files

2D Viewer
Simple viewer for 2D reading
● Displays cine play
● Allows switching among cross section display types (e.g. axial, sagittal, coronal, etc.)
● Real time stack reconstruction (Joins multiple cross-sectional slices together and displays the
result in Ray summation, MIP, or MinIP mode)
● Links coordinates between series
● Applies the same display position, window width and level, and magnification rate to specified
images while displaying them
● Captures each slice of entire selected series
● Can browse a series list of related study data
● Stores and restores image layout

3D Viewer
Display of 2D cross sections, 3D images and virtual Endoscopy views
● Displays 2D cross sections
● 3D view, edit
● Binocular stereo
Simultaneous display of 3D views with small difference in angle
● Inserts image plane
Inserts 2D cross section planes into 3D view and synchronizes with 2D cross section view
● Effective use of 3D display area.
Can be used as an additional MPR slice without using 3D display
Comparative observation using analysis results from past studies
● Can compare saved snapshots of past studies side by side with current study viewer.
● WW/WL, current position, pan, rotation, and zoom rate can be switched between SYNC/ASYNC.
● Series registration of CT images using position recognition.
Virtual endoscope

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● Show MPR navigator.

Display small versions of axial, coronal, sagittal, and orthogonal planes in the corner, synchronized
with the camera position.
● Automatic fly-through.
Automatically detecting the lumen walls, guide the camera through the center of the lumen just by
turning the mouse wheel.
● Create path movie.
Can record a camera path that moves as directed by the mouse, and create a movie that traverses
the path.
Report
● Outputs observations and images to a report
Macro
● Records and plays based on user operation

4D Viewer
Performs 4D play/edit of multi-phase images, e.g., cardiac images
● Cine play with synchronization between 2D cross sections and 3D images
● Ability to specify display time for each phase in milliseconds or % of the total play time
● Creates movies of all images or only 3D images

3D Comparison
Compares multiple series images in 2D and 3D display
● 2D cross section cine play with synchronization among multiple series
● 3D image synchronization among multiple series
● VOI sphere measurement, view comparison, results capture, ability to save measurement values
and graphs to text file(.csv, .txt)
● 3D viewing, editing, measurement
● Real time stack reconstruction (Joins multiple cross-sectional slices together and displays the
result in Ray summation, MIP, or MinIP mode)
● Registration between series using bed position or spine recognition
● Ability to set up synchronization options
● When using multiple monitors, can synchronize study to be analyzed with selected study on study
list.

Dynamic Data
Display of individual parameter images or time-intensity curves of slices of multi-phase data
● Loads single or multiple slice cine images
● Displays time-intensity curves
● Display histogram
● Displays parameter images (difference, time to peak, max-min, area underneath curve)

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● Point measurement and ROI measurement as a circle, rectangle, control point, or freehand.
Output of measurement results in .csv format
● Displays and edits time

Fusion
Viewer superimposes two 3D intra/intermodality images
● Comparison reading
● Reference reading
● MPR reading
● Overlay or blending is configurable
● Automatic rigid registration
● Manual rigid registration by translation and rotation
● Registration by specifying reference points
● Composites two images using rigid body registration and supports the following post-processing
reconstructions for 3D viewing: rigid body registration (applied only to overlaid image), subtraction
value, absolute subtraction value, addition value, average value, maximum value, minimum value
In case of different modalities, WL conversion can be specified for reconstruction
● Composites two images using rigid body registration and supports the following post-processing
reconstructions for saving as a DICOM image: rigid body registration (applied only to overlaid
image), subtraction value, absolute subtraction value, addition value, average value, maximum
value, minimum value
In case of different modalities, WL conversion can be specified for reconstruction
Comparative observation using analysis results from past studies
● Can compare saved snapshots of past studies side by side with current study viewer.
● WW/WL, current position, pan, rotation, and zoom rate can be switched between SYNC/ASYNC.
● Series registration of CT images using position recognition.

Nuclear Medicine Viewer

Viewer that specializes in fusion display of CT and PET or NM images
● Correlation reading
● Reference reading
● MPR reading
● Overlay or blending is configurable
● Automatic rigid registration
● Manual rigid registration by translation and rotation
● Registration by specifying reference points
Comparative observation using analysis results from past studies
● Can compare saved snapshots of past studies side by side with current study viewer.
● WW/WL, current position, pan, rotation, and zoom rate can be switched between SYNC/ASYNC.
● Series registration of CT images using position recognition.

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3D Compositor
3D viewer which displays up to five 3D images in the same coordinate frame
● Automatically or manually adjusts the position of overlay images in reference to a base image
● Registration by specifying reference points
● Perform series registration of CT images using non-rigid registration and display deformed
images
● Displays multiple overlain 3D images in the VR view
● Displays volume mapping
● Synchronizes all 3D views
● Edits masks for each 3D view
● Inserts 2D MPR cross section planes into each 3D image and synchronizes them with the 2D
slice view display
● Stereoscopic view

Slicer
Observes and prints arbitrary cross sections based on set-up slice line
● Creates arbitrary cross sections by a single slice, multiple slices along a line or a curve
● Sets up slice interval, slice thickness and FOV
● Inserts inset image into each images
● Sorting multiple slices according to position
● Sets up lines for intervertebral and centrum automatically by spinal detection
● Outputs Windows/DICOM printer
● Transfers obtained cross sections to capture box or saves in DICOM format
● Displays CPR along slices
● Enter and display related images

Combination
Combines data taken widely as multiple series and creates compound image
● Signal transformation (density adjustment) for pixels
● Manual rigid registration by translation and rotation
● Specifies range of combination
● Displays orthogonal cross section and MIP of compound image
● Processes by 3D Viewer using compound image
● Saves compound image as other series in DICOM dicom format
● Selects direction on saving in DICOM format from axial direction, sagittal direction, coronal
direction or same direction on reading
Settings
● Selects processing method for overlapped region from maximum value or average value
● Specifies size of shortest side of saved image

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Vessel Extraction
Extracts blood vessels using both pre-contrast and post-contrast CT, and displays the extraction result
● Runs bed removal on loading the image
● Adjustable mixing ratio of pre-contrast images and post-contrast images for displaying 2D cross
section view and 3D view
● Automatic or manual rigid registration
● Can perform registration by specifying reference points
● Can perform non-rigid registration
● After vessels are extracted, they can be viewed as vessel 3D, vessel MIP, vessel+bone,
vessel+calcification, or stereoscopic display
● After extraction, blood vessels are displayable in 3D view, MIP view, or stereoscopic view. Both
blood vessels and bone are displayed in the 3D view
● Saves vessel image to DICOM data
● 3D Viewer is available to open a view of the vessel image
● Can extract cerebral arteries and veins from vessel image
● Can insert image plane into 3D display

Dental MPR
Displays and prints panorama image along dental arch and cross section of Alveolar bone using CT
image
● Sets up position and direction of horizontal cross section
● Displays panorama image
● Displays cross section of Alveolar bone
● Prints using Windows/DICOM printer
● Saves all images (orthogonal cross section, panorama image and cross section of Alveolar bone)
in DICOM format or transfers to capture box
● Can display virtual implant and nerve and set margin of nerve
● VR display of LR view and AP view

ADC Viewer
Calculates and displays ADC Map from MR Diffusion image
● Reads diffusion weighted image
● Reads background image
● Perform registration automatically or manually
● Displays ADC Map and eADC Map
Supported manufacturers: GE, Philips
● Displays maximum and minimum value of ADC
● Measurement of circular, rectangle and freehand ROIs
● Display computed DWI

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2D Fusion
Viewer superimposes two 2D intra/intermodality images
● Fuse 2D or 3D images
● Save created fusion images as a DICOM file

Sector MPR
Observation of sector or rectangular MPR images using CT and MR images with single or multiple
phases
● For images with multiple phases, plays them in cine mode in 2D slice, 3D, or creates sector or
rectangular MPR. Duration of each phase is editable
● Displays a sector shaped cross section MPR image based on specified position and orientation
● Reversible display of gray-scale images
● Applies specified image processing and displays pseudo-shadow behind the region that has
signal value outside the threshold
● Positional link of sector or rectangular MPR image to 2D cross section
● Displaying an overlay of the cross section image of sector or rectangular MPR onto the 3D view
● The target display can be selected from skin surface, heart, and liver. While the overlay image
display can be selected from skin surface, heart, liver, and bone
● Enables changes in the range of the slab thickness in the sector or rectangular MPR view
● Provides a choice of view plane types: sector or rectangle
● Measurement of angle and distance between the puncture position and the target point in
centesis mode

General CPR
Extract vessel path and observe and analyze vessels by CPR.
♦ Display straightened CPR.
♦ Display stretched CPR.
♦ Display projected CPR.
♦ Display multi-path CPR.
♦ Automatic path search, and manual settings.
♦ Semi-automatic path search, and manual settings.
♦ Display graph of mean diameter, projection diameter, area, and mean intensity on the path.
♦ Specify one or more normal diameters and measure stenosis rate of vessels, etc.
♦ Color mapping analysis by assigning colors to signal values of up to 6 levels on the vessel.
♦ SMIP display: MIP rendering display of only vicinity along multiple paths.
♦ Can change CPR display to MIP, MinIP, or RaySum.
♦ Orthogonal view of applying smoothing filter or edge enhancement filter.
♦ Connect path route.
♦ Stenosis measurement.

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♦ Virtual stent graft.

Extract and display aorta
♦ Automatically extract aorta.
♦ Aortic stent placement.
♦ Vessel information display for catheter implantation
Panorama CPR display
♦ Panorama CPR display.

MPR Reformat
Observe and save an arbitrary oblique plane based on scan line that was set
♦ Create arbitrary cross section using axis, line, sector, or circle.
♦ Set slice spacing, thickness, and FOV.
♦ Sort multiple slices according to position.
♦ Transfer obtained slice images to a capture box, or save as DICOM images.

Tx Map
Calculate and display T2* map from MR images
♦ Load diffusion-weighted images.
♦ Display T2* map.
♦ Display max and min T2* values.
♦ ROI measurement using a point, ellipse, rectangle, polygonal line, or free-form shape.
♦ Display time-intensity curve.
♦ 3D display of map image

8.2 Detailed functional specifications for "Synapse 3D Cardiac Tools (option)"

The following are the detailed functional specifications for “Synapse 3D Cardiac Tools (option).”

Coronary Artery Analysis (CT)

Coronary artery analysis of cardiac CT images
● Cross section observation: set simple path, display SlabMIP of any slice thickness, display plaque
overlay
● The phase to be analyzed can be selected from among multiple phases
● Automatically or manually extracts the heart region
● Set center axis of left ventricle
● Extracts coronary artery by either a classifying method or a tracking method
● Auto labeling of major arteries
● Extracts bypass blood vessels
● Edits central lines and contours
● Displays coronary arteries in each of the following views: VR, SMIP, angiography (left, right, left
and right). Aorta segmentation result can be toggled

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● Measures stenosis percentage

● Plaque measurement: Color-classified view of CT values in the plaque area of the coronary
arteries and display of the plaque volume
● Virtual stent grafting
● Runs Cardiac Fusion using the nuclear medicine images
● Saves orthogonal cross section paging, CPR rotation, and CPR translation as a movie, a DICOM
image, or multiple capture images
● Displays orthogonal cross sections with option of applying smoothing or edge enhancement filter
● Related XA Observation: Simultaneously displays 3D image and XA images of the same patient
with the same orientation
● Normal view, slice view, MPR view, oblique view, cross section view, simple view layout,
horizontal view layout, stretched CPR layout, customized layout
● CPR observation: Displays two stretched CPR views side by side and rotates them in sync while
maintaining a 90 degree angle between them
● Chamber views (2 cavities, 3 cavities, 4 cavities, aortic valve)
● Plaque map (bull’s eye plots)
● Creates reports
Displays CPRs of coronary arteries
● Creates magnified views of a selected area in the straightened CPR view and stretched CPR
view
● Displays graph of average diameter, projected length of radius, area, and average signal value
together with the straightened CPR view
● Graph view can be toggled
● Displays a list of cross sections that are orthogonal to given point in the blood vessel
● Displays stretched CPR and 3D views side by side with the same orientation
● Displays enlarged stretched CPRs in relation to the position of orthogonal cross sections
● Synthesizes and displays stretched CPRs of all branches of either left coronary artery or right
coronary artery
Comparative observation using analysis results from past studies
● Can browse and compare current study with saved snapshots of past studies
● WW/WL, current position, pan, rotation, zoom rate, and straightened CPR can be switched
between SYNC/ASYNC
● Can apply analysis results from past studies to current study using non-rigid registration
Macro
● Records and plays based on user operation

Coronary Artery Analysis (MR)

Coronary artery analysis of cardiac MR images
● Cross section observation: set simple path, display SlabMIP of any slice thickness
● Automatically or manually extracts the heart region

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● Extracts coronary artery by either a classifying method or a tracking method

● Extracts bypass blood vessels
● Edits central lines and contours
● Displays coronary arteries in each of the following views: VR, SMIP, angiography (left, right, left
and right). Aorta segmentation result can be toggled
● Measures stenosis percentage
● Virtual stent grafting
● Runs Cardiac Fusion using the nuclear medicine images
● Saves orthogonal cross section paging, CPR rotation, and CPR translation as a movie, a DICOM
image, or multiple capture images
● Displays orthogonal cross sections with option of applying smoothing or edge enhancement filter
● Related XA Observation: Simultaneously displays 3D image and XA images of the same patient
with the same orientation
● Slice view, axial view, MPR view, oblique view, cross section view, simple view layout, horizontal
view layout, stretched CPR layout, customized layout
● CPR observation: Displays two stretched CPR views side by side and rotates them in sync while
maintaining a 90 degree angle between them
● Creates reports
Displays CPRs of coronary arteries
● Creates magnified views of a selected area in the straightened CPR view and stretched CPR
view
● Displays graph of average diameter, projected length of radius, area, and average signal value
together with the straightened CPR view
● Graph view can be toggled
● Displays a list of cross sections that are orthogonal to given point in the blood vessel
● Displays stretched CPR and 3D views side by side with the same orientation
● Displays enlarged stretched CPRs in relation to the position of orthogonal cross sections
● Synthesizes and displays stretched CPRs of all branches of either left coronary artery or right
coronary artery

Functional Cardiac Analysis (CT)

Cardiac function analysis with cardiac CT cine images
● Automatic extraction of heart region and manual modification
● Automatic long axis positioning
● 4D cine play
● Creates 4D movie
● Chamber views (2 cavities, 3 cavities, 4 cavities, aortic valve)
● Specifies cardiac base and apex for all phases or individual phase, then specifies the center
position for each slice in the short axis views
● Auto-detect contour of left ventricle, myocardium, and right ventricle

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● Manually set contour of left ventricle in a short axis image

● Manually set contour of myocardium, and right ventricle in a long axis image or short axis image
● Intermediate phase contours are interpolated based on setting of contours of ventricle and
myocardium on one or more slices in the short axis view
● Results display: End-diastolic volume (EDV), end-systolic volume (ESV), end-diastolic volume
index (EDVI), end-systolic volume infarction (ESVI), stroke volume (SV), cardiac output (CO),
cardiac infraction (CI), peak filling rate (PFR), time to peak filling (TPF), ejection fraction (EF), body
surface area, myocardium weight
● Display of bull’s eye plots: Ventricular internal radius, region ejection fraction, wall thickness,
amount of change in wall thickness, increase rate of wall thickness, momentum of wall motion, etc.
● Displays ventricular volume curve
● Displays overlay of the mapping image of each bull’s eye plot onto the ventricular contours for
surface rendering
● Displays myocardial region
● Displays volume data with highlighted left ventricle, left atrium, and cardiac vessels in 2D
cross-sectional view
● Can specify how to handle papillary muscle volume (in ventricle or in myocardium)
● Outputs analytical values, bull’s eye plots, ventricular volume curve, observations, and images to
a report
● Calls Cardiac Fusion to overlay the Cardiac Function analysis results onto the heart surface
together with the Coronary Artery analysis results

Functional Cardiac Analysis (MR)

Cardiac function analysis with cardiac MR cine images
● 4D cine play
● Creates 4D movie
● Specifies cardiac base and apex for all phases or individual phase, then specifies the center
position for each slice in the short axis views
● Automatic extraction of contours of left ventricle and myocardium
● Manual selection of contours of left ventricle and myocardium in the short axis views
● Intermediate phase contours are interpolated based on setting of contours of ventricle and
myocardium on one or more slices in the short axis view
● Results display: End-diastolic volume (EDV), endsystolic volume (ESV), end-diastolic volume
index (EDVI), endsystolic volume infarction (ESVI), stroke volume (SV), cardiac output (CO),
cardiac infraction (CI), peak filling rate (PFR), time to peak filling (TPF), ejection fraction (EF), body
surface area, myocardium weight
● Display of bull’s eye plots: Ventricular internal radius, region ejection fraction, wall thickness,
amount of change in wall thickness, increase rate of wall thickness, momentum of wall motion, etc.
● Displays ventricular volume curve
● Displays overlay of the mapping image of each bull’s eye onto the ventricular contour for surface

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rendering
● Displays myocardial region
● Can specify how to handle papillary muscle volume (in ventricle or in myocardium)
● Outputs analytical values, bull’s eye plots, ventricular volume curve, observations, and images to
a report
● Calls Cardiac Fusion to overlay the Cardiac Function analysis results onto the heart surface
together with the Coronary Artery analysis results

Calcium Scoring
Using non-contrast CT images, this plugin creates a color-classified view of plaque area in the coronary
arteries and calculates the Agatston score
● Automatic extraction of heart
● Calculates the number of plaques for each vessel (LM/LAD/LCX/RCA), volume (area), Agatston
score, integration score per voxel, mean CT value, and maximum CT value
● Specifies plaque region
● Supports creation of new vessel regions for scoring
● Saves the scoring result to a .csv file or a .txt file, or captures the result
● Outputs scoring results, observations, and images to a report

Cardiac Fusion
Display a bull's eye and a mapping of the nuclear medicine image to the 3D heart surface, which are
obtained by the cardiac function analysis system application
● Overlays bull’s eye images onto the base image, making out of range pixels transparent
● Can perform Stress/Rest calculation and results mapping using nuclear medical images
● Displays coronary artery regions together with nuclear medical images
● Maps images of cardiac function or nuclear medicine onto the left ventricle image
● Selectable view of cardiac 3D images: the entire heart, the origins of arteries, or the left ventricle
● Displays an overlay of the images of cardiac function or nuclear medicine onto the CPR image
● Displays axial/sagittal/coronal/long-axis/short-axis views. When structure image is different from
function image, fusion is available to display a superimposed image
● Registration
● Creates reports
Displays bull's eye
● Transforms bull’s eye plots for display according to the length of the coronary arteries
● Inverse display of bull's eye
● Changes the range of colors by specifying the upper limit and the lower limit
● Displays Topographic map

Aortic Valve Analysis

Using single or multiple phase cardiac CT images, measure an aortic valve

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♦ Cine play synchronized with 2D slice images and 3D images.

♦ Can change specification of display time for each phase to be shown in milliseconds or as a
percentage of overall playback time.
♦ Create a 4D movie of the entire display image, or of the 3D view only.
♦ Automatically extract heart.
♦ Measurement near aortic valve function.
♦ Plaque measurement: color-coded display of CT values.
♦ Virtual valve placement.
♦ Plaque measurement of internal virtual valve only.
♦ Insert image planes.
♦ Output various measurement values, analysis values, and images to report.
♦ Observation using oblique three planes
♦ Display body surface and ribs for transapical approach
♦ Creates report based on measurement results in ST Junction, Sinus of Valsalva, Annulus and
optional plane

Flow Analysis (MR)

Analyze blood flow velocity using single or multiple cross-sectional multi-phase images
♦ Display blood flow image.
♦ Display original image, phase image, or absolute value image overlapped with the blood flow
velocity image.
♦ Display time-intensity curve.
♦ ROI measurement in a circle, rectangle, or freehand curve. Measurement results can be output
as CSV file.
♦ Display and edit time.

4 chamber analysis
Perform cardiac function analysis on the four chambers (left ventricle, right ventricle, left atrium, right
atrium) in CT Cine images of the heart
♦ Automatic extraction of heart with manual correction.
♦ Automatic extraction of 4 chambers of heart with manual correction.
♦ Automatic setting of long axis with manual correction.
♦ 4D Cine play.
♦ 4D movie creation.
♦ Chamber list view (2-chamber, 3-chamber, 4-chamber, aortic valve).
♦ Specify apex and base for each phase or all phases, and specify center position of each slice
(short-axis image).
♦ Auto-detect contour of left ventricle and myocardium.

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♦ Display results: end-diastolic volume (EDV), end-systolic volume (ESV), end-diastolic volume
index (EDVI), end-systolic volume index (ESVI), stroke volume (SV), cardiac output (CO),
cardiac index (CI), peak filling rate (PFR), time to peak filling (TPF), ejection fraction (EF), body
surface area, myocardial mass.
♦ Bull's eye display: ventricular radius, region EF, wall thickness, wall thickening rate, wall motion,
etc.
♦ Display EF curve of 4 chamber region.
♦ Display surface of each 4 chamber region.
♦ Surface display that maps each bull's eye color to surface of ventricle.
♦ Display myocardial regions.
♦ Choice of whether to include volume of ventricular papillary muscles in either ventricle or
myocardium.
♦ Output analysis values, bull's eye, EF curve, observation, and images to a report.
♦ Non-rigid registration between phases.
♦ Bull's eye display of parameters using information from non-rigid registration between phases.
♦ Can start cardiac fusion in conjunction with results of coronary analysis, and map results of 4
chamber analysis onto surface of heart.

Cardiac Ablation Analysis

● Automatic extraction of the heart
● Automatic extraction of ventricular, atrial, and myocardial regions
● Extraction of the pulmonary vein based on the left atrium region
● ROI-based extraction of the gullet region
● 3D view inside the pulmonary vein
● Virtual endoscopic view of inside the pulmonary vein
● Observation of display planes in a virtual endoscopic view
● Output cine movies

8.3 Detailed functional specifications for "Synapse 3D Brain Perfusion (option)"

The following are the detailed functional specifications for “Synapse 3D Brain Perfusion (option).”

Brain perfusion (CT)

CT cerebral perfusion analysis
● Loads and analyzes single or multiple slice images
● Automatic rigid registration of images of the same slice among different phases
● Automatic detection or manual selection of the positions of arteries and veins
● Plays cine of cross section images
● Calculates CBV/MTT/CBF/TTP images
● Superposes original image and parameter images

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● Sets up removal rate of blood vessels

● ROI setting (symmetric ROI is available)
● Manage ROI templates
● Displays time-intensity curve
● Stores graphs in csv format
● Sets up whether to perform delay correction by bSVD
● Sets up pseudo-color of parameter image
● Set how to obtain time information

Brain Perfusion (MR)

MR cerebral perfusion analysis
● Loads and analyzes single or multiple slice images
● Automatic rigid registration of images of the same slice among different phases
● Automatic detection or manual selection of the positions of arteries and veins
● Plays cine of cross section images
● Calculates CBV/MTT/CBF/TTP images
● Superposes original image and parameter images
● Sets up removal rate of blood vessels
● ROI setting (symmetric ROI is available)
● Manage ROI templates
● Displays time-intensity curve
● Stores graphs in csv format
● Sets up whether to perform delay correction by bSVD
● Sets up pseudo-color of parameter image
● Displays result image overlapped with ADC Map by reading Diffusion image (with or without
MPG) together
● Displays other image (T2W and FLAIR et al.) overlapped with ADC Map by reading other image
together
● Set how to obtain time information

4D Perfusion
Perfusion analysis of 3D CTs of the head
♦ Load and analyze three-dimensional images.
♦ Automatically detect positions of arteries and veins, or set them manually.
♦ Can perform Cine playing of slice images or 3D images.
♦ Calculate CBV/MTT/CBF/TTP images.
♦ Overlay display of a parameter image and original image.
♦ Set vessel removal ratio.
♦ Set ROI (can also set symmetrical ROI).
♦ Display time-intensity curve.
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♦ Save graph in csv format.

♦ Set delay correction with bSVD.
♦ Set pseudo-color in parameter image.

8.4 Detailed functional specifications for "Synapse 3D Lung and Abdomen Analysis (option)"
The following are the detailed functional specifications for “Synapse 3D Lung and Abdomen Analysis (option).”

Lung Analysis (CT)

Using CT images, this plugin calculates volume of lung nodules and displays low attenuation areas
● Semi-automatic extraction of 5 lobes of the lung
● Separates right and left lungs automatically
● Automatic extraction of lung field
● Automatic removal of airways
● Outputs nodule list, observation, images to the report
● Automatically extract contact surface between diaphragm and lungs
Lung nodule
● Semi-automatic extraction of nodules by selecting position or contours
● Displays the region around the nodule in the 2D cross section view or the 3D view, or displays the
entire region
● Lists volume, maximum CT value, mean CT value, and standard deviation for each nodule
● Displays intensity histogram for each nodule
● Can capture the nodule list and histograms or save them to a file
Airway analysis
● Selects the paths of airway
● Adds and deletes paths and edits central lines and contours
● Displays CPRs of the paths of airway
● Displays diameter information of paths on CPR and graph
● Labels to airway on specified position
● Extracts lung field occupied by labeled airways
Displays low attenuation areas
● Displays an overlay of the color coded image onto the lung region in 2D view
● Individually displays the results of analysis for right and left lung, lung lobes and regions occupied
by airways
● Calculates histogram of the inside of the lung field
● Displays an overlay of the low attenuation areas onto the surface of the lung
● Calculates the volume of the region specified by each intensity range as well as the percentage of
the lung field made up by that region
● Allows registering and editing the color code of low attenuation areas

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● Can capture the histogram and the volume list of each region or save them to a file
Cluster analysis
● Classifies low attenuation areas by clustering
● Clustering analysis based on 2D connection components
● Clustering analysis based on 3D connection components
● Overlays colors according to cluster size onto lung region on 2D cross sections
● Displays spheres according to cluster size onto 3D image
● Displays log-log graph made by horizontal axis corresponding to the volume and vertical axis
corresponding to the number.
● Displays regression line for log-log graph
Compare to analysis results of past studies
● Comparison of tumor over time
● Comparison of airway analysis over time
● Comparison of low attenuation area over time
● Comparison of cluster analysis over time

2D Fat Analysis (CT)

Measurement of visceral and subcutaneous fat area by using a single abdomen CT image
● Automatic detection of subcutaneous fat and visceral fat
● Automatic recognition of umbilicus position on loading images
● Manual correction to the result of automatic detection of subcutaneous fat and visceral fat
● Calculation of the area of subcutaneous fat and visceral fat
● Calculation of circumference of body surface
● Calculation of BMI
● Output to reports: Total area of fat, area of subcutaneous fat, area of visceral fat, abdominal girth,
BMI, diagnostic result, comments, and images

3D Fat Analysis (CT)

Calculates volume and percentage of visceral fat and subcutaneous fat using 3D CT abdominal images
● Automatic detection of subcutaneous fat and visceral fat and psoas major
● Automatic recognition of upper surface of the diaphragm, pubic symphysis, and umbilicus position
● Manual correction to the result of automatic detection of subcutaneous fat, visceral fat and psoas
major
● Calculation of the area of subcutaneous fat and visceral fat
● Calculation of fat percentage in the region for analysis
● Calculation of circumference of body surface
● Displays an overlay of the frequency distribution of both subcutaneous fat and visceral fat onto
the surface of the 3D view
● Calculation of BMI
● Output to reports: Total area of fat, area of subcutaneous fat, area of visceral fat, abdominal girth,

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BMI, volume of visceral fat, volume of subcutaneous fat, volume percentage of body fat, volume
percentage of subcutaneous fat, diagnostic result, comments, and images
● Calculation of the specified region volume of the psoas major

Lung Analysis Scope (CT)

Using CT images, find optimal bronchus path leading to lung nodule
♦ Automatically extract lung region.
♦ Automatically extract airway region.
♦ Output observations and images to a report.
Extraction of lung nodules and optimal path
♦ Specify diameter of lung nodules and perform semi-automatic extraction.
♦ Extract optimal path leading to lung nodule.
♦ Save optimal path list as a capture or file.
♦ Add and remove paths.
♦ CPR display of optimal path.
♦ Set lymph nodes present in vicinity of path.
Checking optimal path
♦ Endoscopic view of optimal path.
♦ Can record any position on optimal path.
♦ Create movie of endoscope advancing through optimal path.
♦ Sheer display of endoscopic image.
♦ Automatically update opacity of endoscopic image based on progress of endoscope.

Lung Analysis Resection (CT)

Using CT images, extract lung, bronchus, tumor, and pulmonary vessels and simulate lung resection
♦ Extract the 5 lobes semi-automatically.
♦ Automatically separate left and right lungs.
♦ Automatically extract lung region.
♦ Automatically remove airway region.
♦ Automatically extract contact surface between diaphragm and lungs.
♦ Output nodule list, observations, and images to a report.
Extraction of tumor
♦ Specify the contour or the position and diameter of tumor and perform semi-automatic
extraction.
♦ Local or overall view of 2D slice or 3D image near tumor.
♦ For each tumor, list its volume, maximum CT value, minimum CT value, mean CT value, and
standard deviation.
♦ Histograms of each tumor.
♦ Save tumor list and histogram as a capture or file.
Extraction of PV/PA and bronchus

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♦ Specify center of PV/PA.

♦ Semi-automatically extract pulmonary vessels.
♦ Add and remove portions while extracting PV/PA and bronchus.
♦ Replace extracted PA and PV.
♦ Show/hide the extracted path.
♦ Save study list as a capture or file.
♦ Automatically extract bone and body surface regions.
Division of the lung region
♦ Extract lung field region occupied by specified sub-tree of PV/PA and bronchus.
♦ Arbitrary division of lung region.
♦ Edit occupied region and its border.
♦ Surface rendering of region.
♦ Insert image plane into 3D display.
♦ Cut plane display: paste slice MPR in 3D image.
♦ Measure distance between tumor and plane.
♦ Can record division method

Lung Analysis Scope (CT)

Using CT images, find optimal bronchus path leading to lung nodule
♦ Automatically extract lung region.
♦ Automatically extract airway region.
♦ Output observations and images to a report.
Extraction of lung nodules and optimal path
♦ Specify diameter of lung nodules and perform semi-automatic extraction.
♦ Extract optimal path leading to lung nodule.
♦ Save optimal path list as a capture or file.
♦ Add and remove paths.
♦ CPR display of optimal path.
♦ Set lymph nodes present in vicinity of path.
Checking optimal path
♦ Endoscopic view of optimal path.
♦ Can record any position on optimal path.
♦ Create movie of endoscope advancing through optimal path.
♦ Sheer display of endoscopic image.
♦ Automatically update opacity of endoscopic image based on progress of endoscope.

8.5 Detailed functional specifications for "Synapse 3D Liver and Kidney Analysis (option)"
The following are the detailed functional specifications for “Synapse 3D Liver and Kidney Analysis (option).”

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Liver Analysis (CT)

Using contrast CT images, this plugin performs liver extraction and extraction of individual blood vessel
regions. It displays the extraction results in the 3D view
● Loads artery images, portal images, and equilibrium images at the same time
● Manual and automatic rigid registration of each phase
● Automatic non-rigid registration
● Automatic extraction of liver
● Extraction of inferior vena cava by setting ROI in multiple slices
● Extraction of artery, portal, vein, and bile duct
● Extraction of high density and low density tumors
● Extraction of body surface, bone region and gallbladder
● Extraction of arbitrary region
● Displays the length of the segment specified in extracted blood vessels
Extraction of each region of the liver
● Divides the liver into multiple regions by either manual operation or automatic estimation of the
blood vessels’ affected regions
● Displays volume of each divided region of the liver
● Displays volume of each divided region of the liver after removing the surrounding organs such as
blood vessels
● Performs mask operator calculations: reverse, addition, subtraction, logical conjunction, exclusive
OR, and swapping among divided regions
● Saves methods of dividing regions
Liver observation
● Displays an image plane inserted in the volume image in the 3D view
● Surface smoothing is available in the 3D view
● Displays liver regions and blood vessel regions with surface rendering
● Displays cut planes: MPR cut plane in the 3D view
● Simulates removal of tumor region
● Display organs near cut plane of region division
● Display sector MPR images
● Output liver region information from the results of the region division to a report

Liver Analysis (MR)

Perform observation and analysis of contrast-enhanced images using abdominal MR images
● Load multi-phase images of different times.
● Load non-contrast-enhanced images as reference images.
● Comparison display of local viewing areas.
● Simultaneous display of regions of interest for multi-phase images.
● Image registration between multi-phase images.

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● Extract liver and spleen based on specified region.

● Display results of image calculation by user-specified formula.
● Pseudo-color display of calculation result image.
● Overlay display of calculation result image and original image.

Kidney Analysis (CT)

Using contrast-enhanced CT images of kidney, perform extraction of kidney and each vessel region, and
view results in 3D.
● Load artery images, corticomedullary images, nephrographic images, and excretory images at
the same time.
● Manual and automatic rigid registration of each phase.
● Semi-automatic extraction of kidney.
● Extraction of cortex and medulla.
● Extraction of artery, portal, and bile duct.
● Extraction of tumor and calculus.
● Extraction of body surface and bone region.
● Extraction of arbitrary region.
Extraction of each region of kidney
● Divides the kidney into multiple regions by either manual operation or automatic estimation of the
blood vessels’ affected region.
● Displays volume of each divided region of the kidney.
● Displays volume of each divided region of the kidney after removing the surrounding organs such
as blood vessels.
● Performs mask operator calculations: reverse, addition, subtraction, logical conjunction, exclusive
OR, and swapping among divided regions.
● Saves methods of dividing regions.
Observation of kidney
● Displays an image plane inserted in the volume image in the 3D view
● Surface smoothing is available in the 3D view
● Displays kidney regions and blood vessel regions with surface rendering
● Displays cut planes: MPR cut plane in the 3D view
● Simulates removal of tumor region
● Displays cut planes of divided region
● Utilizes Sector MPR in Kidney Analysis
● Outputs information for each divided kidney to report

8.6 Detailed functional specifications for "Synapse 3D Nodule Analysis (option)"

The following are the detailed functional specifications for “Synapse 3D Nodule Analysis (option).”

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RECIST tracker (CT, CT/PET)

Using CT image mainly, tracks temporal changes of a tumor
● Registration between PET image and CT image
● Extracts a tumor by specifying diameter
● Displays histogram of lesions
● Registers, displays and evaluates tumors
● Output to reports on each state of approve, determine and overall determine
● Compares with previous study
● Selects tumor evaluation criteria from WHO, RECIST1.0

PERCIST tracker (PET, CT/PET)

Using PET image manly, tracks temporal changes of a tumor
● Registration between PET image and CT image
● Calculates maximum averaged SUV on specified position using sphere VOI
● Registers, displays and evaluates tumors
● Output to reports on each state of approve, determine and overall determine
● Compares with previous study

8.7 Detailed functional specifications for "Synapse 3D Colon Analysis (option)"

The following are the detailed functional specifications for “Synapse 3D Colon Analysis (option).”

Colon Analysis (CT)

Perform Observation by generating a path through the colon from CT image
● Load one or both of the supine and prone position images.
● Can automatically extract the colon, and add manually if that is not sufficient
● Can semi-automatically specify a path through the extracted colon.
● Show display region (whole or local), display method (colon near surface, AirWay, RaySum),
surface display (airway surface, airway internal, external surface).
● Virtual endoscopy view of colon along the path.
● Walk-through function.
● Create movie for virtual endoscope.
● Unfolded cube view display.
● Display straight open view.
● Display straight cross-section view.
● Depth MIP display of thickness from wall for virtual endoscope and each straight open view.
● Can record positions of lesions such as a polyps.
● Digital cleansing.
● Simultaneous display of images before and after execution of cleansing.
● Can edit cleansing area.

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● Synchronize two images.

● Can register recorded positions of a lesion between two images as a pair.

8.8 Detailed functional specifications for "Synapse 3D Tensor Analysis (option)"

The following are the detailed functional specifications for “Synapse 3D Tensor Analysis (option).”

Craniotomy Simulator/Tensor Analysis (CT, MR)

From MR images of the head, perform tensor analysis, and visualize the white matter tractography
From MR images of the head, perform craniotomy simulation
● Load diffusion-weighted images.
● Calculate FA value and diffusion color map by tensor analysis.
● ROI measurement using an oval, rectangle, free-form shape, or sphere.
● Insert image planes.
● Place oval, rectangle, free form shape, or sphere, execute tractography, and then display results
of tensor analysis as white matter tractography in 3D view.
● If multiple images were entered, align them.
Organ extraction from CT images
● Extract body surface, bone, brain, tumor, artery, vein, or arbitrary region
● Can extract multiple tumor regions and calculate the volume of each.
Craniotomy simulation
● Multi 3D display of extracted region.
● Specify region and then make incision in surface and bone.
● Can record division method

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